Detection of bronchial squamous dysplasia using high magnification bronchovideoscopy and angiogenesis of multi step carcinogenesis of squamous cell carcinoma

本研究的目的是探讨高放大率支气管视频内窥镜在详细检查粘膜荧光异常患者支气管粘膜异型增生中的价值。本研究中使用了高放大率支气管视频镜（XBF 200 HM 2）。共有31例痰细胞学可疑或恶性肿瘤阳性的患者入组研究。首先在局部麻醉下对患者进行常规白光检查。荧光支气管镜检查也使用LIFE肺系统进行。然后，主要在正常和异常荧光部位通过高倍支气管视频镜进行高倍观察，以检查支气管粘膜中的微血管网。通过高放大率支气管视频内窥镜获得的图像与支气管活检标本的病理诊断进行比较。对于高放大率支气管视频镜获得的血管模式， 关于我们 使用图像分析装置计算EA比并进行比较。在22个支气管炎异常荧光部位中，有20个观察到规则的肌肉网络。然而，在21个异常荧光部位中的15个中观察到血管生长增加的血管网络和各种大小的曲折血管的复杂网络。支气管炎和发育不良之间存在显著差异（OR-25，95%CI，5.5至113，p<0.0001）。血管面积与平均值的比值16例正常荧光部位的正常支气管上皮、22例支气管炎和21例异常荧光部位的异型增生的95%置信区间（CI）为0.054（95%CI=0.039至0.07）、0.095（95%CI=0.072至0.118）和0.173（95%CI=0.143至0.203）。结果表明，三组中血管面积值在统计学上显著增加（p <0.0001）。我们的研究结果表明，在支气管粘膜中，通过高倍镜在异常荧光部位检测到血管生长增加的区域和复杂的迂曲血管网络，可以区分支气管炎和异型增生。

The purpose of this study was to investigate the value of high-magnification bronchovideoscopy in detailed examination of dysplasia in the bronchial mucosa of patients exhibiting abnormal mucosal fluorescence. A high-magnification bronchovideoscope (XBF 200HM2) was used in this study. A total of 31 patients with sputum cytology suspicious or positive for malignancy were entered into the study. Conventional white-light examination was first performed on patients under local anesthesia. Fluorescence bronchoscopic examination was also caned out using a LIFE lung-system. Then, high-magnification observation was performed by high-magnification bronchovideoscopy primarily at sites of normal and abnormal fluorescence to examine the microvascular network in the bronchial mucosa. Images obtained by high-magnification bronchovideoscopy were compared with pathological diagnoses from bronchial biopsy specimens. For the vascular patterns obtained by high-magnification bronchovideoscopy, vascular ar … More ea ratios were calculated using an image-analyzing apparatus and compared. Mascular networks with regular patterns were observed in 20 of 22 abnormal fluorescence sites with bronchitis. However, vascular networks with increased vessel growth and complex networks of tortuous vessels of various sizes were observed in 15 of 21 abnormal fluorescence sites with dysplasia. There was a significant difference between bronchitis and dysplasia (OR-25, 95%CI, 5.5 to 113, p<0.0001). Vascular area ratios with the means (95% confidence interval [CI])from the 16 normal bronchial epithelium at sites of normal fluorescence, 22 bronchitis and 21 dysplasia at sites of abnormal fluorescence, were 0.054 (95%CI=0.039 to 0.07), 0.095 (95%CI=0.072 to 0.118), and 0.173 (95%CI=0.143 to 0.203), respectively. The results indicated a statistically significant increase in vascular area values in the three group (p <0.0001). Our results showed that areas of increased vessel growth and complex networks of tortuous vessels in the bronchial mucosa detected by high magnification bronchovideoscope at sites of abnormal fluorescence may allow for discrimination between bronchitis and dysplasia Less